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Monday, August 27, 2012

One of the most pressing issues facing Indiana's next governor when he takes office next year is how the state will deal with health care exchanges, which provide a marketplace for consumers and business owners to shop for health insurance policies, mandated under the federal Affordable Care Act. U.S. Rep. Mike Pence says he doesn't want the state to set up a state-run health care exchange using federal grant money because he doesn't like Obamacare and believes its legal certainty is in doubt. In the absence of a state health care exchange, federal bureaucrats will tailor a plan for Indiana's citizens to its liking. His Democratic opponent, John Gregg, takes a more rational approach to the issue in suggesting the state should adopt some hybrid approach in conjunction with the federal government. Quoting Howey Politics, Gregg said Pence's approach would put Indiana "at the mercy of the federal government." "I want to make this clear, it does not matter whether you support the Affordable Care Act or not," Gregg said. "Whether you love it or hate it, it is the law of the land. My job as governor will be protect the best interests of the people of this state and enforce the law in a way that will benefit all Hoosiers and makes healthcare more affordable and more accessible for all Hoosiers." Gregg accuses Pence of "abdicat[ing] his responsibility and throw[ing] Hoosiers under the federal bureaucracy bus." Here's how Gregg suggested Indiana should confront this issue:

"First, the federal government is very prescriptive as it
relates to EHB plans," Gregg explained. "In order to assist states in the
selection of minimum benefits for plans in the Exchange, the federal government
has named four options, all of which must cover services in ten different areas.
I fully support the Healthy Indiana Plan benefit levels. However, the federal
government requires maternity benefits and HIP does not pay for those services
at this time. Indiana's EHB must include the 10 required covered services and
should include as many non-mandated, but necessary services as
possible. Accordingly, I support using Indiana's Healthy Indiana Plan as the
basis for our EHB plan, with additional coverage as required by the federal
government.

"Second," Gregg said, "the federal government has offered
several options to states in moving forward on an Exchange. States may choose a
state-designed and controlled Exchange; they can choose a hybrid system that
allows for a partnership with the federal government but still allows for state
control; or they can choose a regional partnership with other states. The only
other option is for a federally controlled Exchange where the state does not
have the ability to provide input, but its citizens must participate. At the
present time, we are leaning toward choosing the hybrid system that not only
allows for a federal-state partnership, but also allows for shared costs,
significantly reducing the state's financial investment in the program."

Gregg added, "Our belief is that the most responsible position for the
Governor to take is the one that Governor Daniels has been pursuing all along -
to meet deadlines and apply for grant monies available to keep all options open
to us. Because of the actions taken by Governor Daniels, Indiana has already
received $8 million to start this process."

Pence responded by defending his position that the state should have no part of implementing any part of Obamacare. Pence says that he chooses "more freedom, more innovation, and Hoosier solutions over Obamacare." Unfortunately, that's a choice that has already been made for the state. All citizens are subject to the ACA whether they like it or not. Congress passed it, the President signed it and the Supreme Court upheld its constitutionality. Maybe Pence can read the tea leaves better than the rest of us and know for certain that a President and Congress will be elected to office this year who will repeal the ACA. I find that hard to swallow. Even if Mitt Romney wins as I hope and pray, many aspects of the ACA are similar to the Romney Care plan Gov. Romney enacted when he was governor of Massachusetts. My guess is that he will adopt an approach of "mending it, not ending it," to coin a phrase used by Rev. Jesse Jackson, since he said during his interview with NBC this weekend that he was proud of the health care plan he adopted when he was governor, which the late Sen. Ted Kennedy supported and helped Romney secure votes in the Democratic-controlled legislature to pass.

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